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Individual

STEPHEN MARTIN FISHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
4803 WARD RD, WHEAT RIDGE, CO 80033-1902
(303) 338-3800
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
1333
AZ
152W00000X
Optometrist
Primary
2368
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
021010
KAISER COMMERCIAL NUMBER
CO
01
1333
STATE LICENSE
AZ
05
90476522
CO
Enumeration date
06/26/2006
Last updated
05/20/2021
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